Method and apparatus for coupling soft tissue to bone

Abstract

A method and apparatus for securing a suture to bone can include grasping a first suture portion with a grasping member on a positioning tool. The first suture portion can be located into a first cannulation defined in the positioning tool. A cutting member can be advanced through a second cannulation defined on the positioning tool and out through a distal opening defined on the positioning tool. A first bone hole can be cut into the bone with the cutting member. A flexible member advancing tool can be advanced through the first cannulation. The first suture portion can be urged out of the distal opening and into the first bone hole.

What is claimed is: 
     
       1. A flexible member securing assembly for use in securing a flexible member relative to bone, the assembly comprising:
 an actuating tool including an elongated member that extends between a proximal user engaging end and a distal actuating end, the proximal user engaging end including a user actuating portion, the distal actuating end including an actuating member; 
 a drill driver; and 
 a positioning tool including:
 a body that extends between a proximal receiving end and a distal positioning end, 
 a grasping member movably coupled to the body between an open grasping position and a closed securing position to secure the flexible member, 
 a first cannulation formed in the body, the first cannulation configured to receive the actuating member, such that movement of the actuating member urges the grasping member toward the open grasping position, 
 a distinct second cannulation formed in the body, the second cannulation configured to receive the drill driver to form a bone hole, 
 a converging cannulation portion formed in the body proximate the distal positioning end, wherein the first and second cannulations converge at the converging cannulation portion into a common cannulation portion at the distal positioning end, and 
 a first proximal opening formed in the body, 
 
 wherein the grasping member is configured to secure the flexible member in the securing position while the bone hole is being formed by the drill driver extending through the common cannulation portion. 
 
     
     
       2. The flexible member securing assembly of  claim 1  wherein the body comprises a ramp formed at the converging cannulation portion. 
     
     
       3. The flexible member securing assembly of  claim 1  wherein the body further comprises a second proximal opening and a common distal opening. 
     
     
       4. The flexible member securing assembly of  claim 3  wherein the body defines a slot that connects the common distal opening and the first cannulation. 
     
     
       5. The flexible member securing assembly of  claim 3 , further comprising:
 a flexible member advancing tool that is configured to be slidably received in the first proximal opening and to a first position that engages the flexible member adjacent the grasping member to a second position that advances the flexible member through the distal opening. 
 
     
     
       6. The flexible member securing assembly of  claim 1  wherein the first and second cannulations are parallel and offset. 
     
     
       7. The flexible member securing assembly of  claim 1  wherein the grasping member is hingedly coupled to the body. 
     
     
       8. The flexible member securing assembly of  claim 1  wherein the grasping member is biased toward the closed securing position. 
     
     
       9. The flexible member securing assembly of  claim 1  wherein the first proximal opening is configured to receive the distal actuating end of the actuating tool and at least a portion of the elongated member, wherein movement of the user actuating portion urges the actuating member to ride on a surface of the body and urge a tang on the grasping member away from the first cannulation. 
     
     
       10. The flexible member securing assembly of  claim 1 , wherein:
 the first cannulation is configured to receive the actuating tool such that the actuating member can engage the grasping member; 
 the actuating member is configured to urge the grasping member into the open grasping position, such that the grasping member can receive the flexible member; 
 the grasping member is configured to secure the flexible member in the closed securing position such that a flexible member advancing tool in the first cannulation can engage the flexible member and advance the flexible member through the distal opening. 
 
     
     
       11. An assembly comprising:
 an actuating tool including an elongated member that extends between a proximal user engaging end and a distal actuating end, the distal actuating end including a cam member; 
 a drill driver; and 
 a positioning tool including a body that extends between a proximal receiving end and a distal positioning end, first and second cannulations formed in the body, wherein the first cannulation is configured to receive the actuating tool, a converging cannulation portion formed in the body proximate the distal positioning end, wherein the first and second cannulations converge at the converging cannulation portion at the distal positioning end, a first proximal opening formed in the body, and a grasping member movably coupled to the body between an open grasping position and a closed securing position; wherein the actuating tool is configured to be rotated within the first cannulation such that the cam member urges the grasping member toward the open grasping position, wherein the grasping member is configured to receive a flexible member so as to secure the flexible member relative to bone, wherein the second cannulation is configured to receive the drill driver that can extend through the converging cannulation portion to form a bone hole, wherein the positioning tool is configured to allow secure the flexible member in the closed securing position while the drill driver is operating to form the bone hole. 
 
     
     
       12. The assembly of  claim 11  wherein the body further comprises a second proximal opening and a common distal opening. 
     
     
       13. The assembly of  claim 12  wherein the body defines a slot that connects the common distal opening and the first cannulation. 
     
     
       14. The assembly of  claim 12  wherein the body comprises a ramp formed at the converging cannulation portion. 
     
     
       15. The assembly of  claim 14 , wherein the ramp is configured to guide the flexible member out of the converging cannulation portion through the common distal opening. 
     
     
       16. The assembly of  claim 11  wherein the first and second cannulations are parallel and offset. 
     
     
       17. The assembly of  claim 11  wherein the grasping member is hingedly coupled to the body and biased toward the closed securing position. 
     
     
       18. The assembly of  claim 11 , further comprising:
 a flexible member advancing tool that is configured to be slidably received in the first proximal opening and to a first position that engages the flexible member adjacent the grasping member to a second position that advances the flexible member through a common distal opening. 
 
     
     
       19. The assembly of  claim 11  wherein the first proximal opening is configured to receive the distal actuating end of the actuating tool and at least a portion of the elongated member, wherein movement of the proximal user engaging rotates the cam member to urge a tang on the grasping member away from the first cannulation.